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糖尿病患者HBV新发感染风险的行为影响因素分析

代雪梅 张茜 张璇 周静 段晓霞 黄金城 廖宇婷 袁萍

代雪梅, 张茜, 张璇, 等. 糖尿病患者HBV新发感染风险的行为影响因素分析[J]. 四川大学学报(医学版), 2021, 52(5): 772-777. doi: 10.12182/20210960301
引用本文: 代雪梅, 张茜, 张璇, 等. 糖尿病患者HBV新发感染风险的行为影响因素分析[J]. 四川大学学报(医学版), 2021, 52(5): 772-777. doi: 10.12182/20210960301
DAI Xue-mei, ZHANG Xi, ZHANG Xuan, et al. Study on Behavioral Factors Affecting the Risk of New HBV Infection among Diabetic Patients[J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION), 2021, 52(5): 772-777. doi: 10.12182/20210960301
Citation: DAI Xue-mei, ZHANG Xi, ZHANG Xuan, et al. Study on Behavioral Factors Affecting the Risk of New HBV Infection among Diabetic Patients[J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION), 2021, 52(5): 772-777. doi: 10.12182/20210960301

糖尿病患者HBV新发感染风险的行为影响因素分析

doi: 10.12182/20210960301
基金项目: “十二五”国家重大科技专项基金(No. 2012ZX10004901)和“十三五”国家重大科技专项基金(No. 2018ZX10715003)资助
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    E-mail:yuanp1117@scu.edu.cn

Study on Behavioral Factors Affecting the Risk of New HBV Infection among Diabetic Patients

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  • 摘要:   目的  探讨糖尿病患者乙型肝炎病毒(hepatitis B virus, HBV)新发感染的行为影响因素,为降低糖尿病患者HBV新发感染风险提供依据。  方法  采用巢式病例对照研究方法,对4 586名糖尿病患者进行随访观察,以随访观察期内新发生HBV感染的114名糖尿病患者为病例组,按年龄±2岁,从队列人群中以1∶2的比例匹配228名同期未发生HBV感染的糖尿病患者为对照组。对队列人群进行问卷调查和实验室检查,问卷内容包括乙肝家族史、外伤史、受/献血史、个体相关行为特征、糖尿病严重程度和糖尿病治疗管理相关行为等,同时采用酶联免疫吸附法(enzyme-linked immunosorbent assay, ELISA)对队列人群的血标本进行乙肝表面抗原(hepatitis B surface antigen, HBsAg)检测。采用条件logistic回归模型分析影响糖尿病患者HBV新发感染的相关行为因素。  结果  病例组与对照组年龄的中位数分别为64岁和66岁,两组的性别、年龄、民族、职业和文化程度构成差异均无统计学意义(P>0.05)。多因素分析结果显示,有乙肝家族史(OR=13.052,95%CI:3.799~44.847)的糖尿病患者HBV新发感染的风险增加;规范使用采血/注射装置(OR=0.189,95%CI:0.082~0.436),使用安全锁卡式血糖针(OR=0.142,95%CI:0.073~0.276)、静脉采血针(OR=0.019,95%CI:0.001~0.262)和在家自检血糖(OR=0.466,95%CI:0.222~0.980)的糖尿病患者HBV新发感染的风险降低。  结论  乙肝家族史是糖尿病患者HBV新发感染风险增加的独立影响因素,在糖尿病患者长期的血糖管理过程中,规范使用采血/注射装置,使用更安全的采血针类型和自检血糖能够降低其发生HBV感染的风险。
  • 图  1  研究对象纳入流程图

    Figure  1.  Flow chart of respondent recruitment for the study

    表  1  病例组与对照组的基本人口学特征

    Table  1.   Social demographic characteristics of the HBV group and the control group

    CharacteristicHBV
    group
    (n=114)
    Control
    group
    (n=228)
    χ2/ZP
    Age/yr., median (P25-P75) 64 (55-70) 66 (62-69) −1.434 0.152
    Sex/case (%) 0.605 0.437
     Male 50 (43.86) 90 (39.47)
     Female 64 (56.14) 138 (60.53)
    Ethnicity/case (%) 0.010 0.919
     Han 94 (82.46) 189 (82.89)
     Others 20 (17.54) 39 (17.11)
    Occupation/case (%) 0.691 0.406
     Farmers 76 (66.67) 162 (71.05)
     Others 38 (33.33) 66 (28.95)
    Formal education/case (%) 1.418 0.492
     Primary school and below 86 (75.44) 171 (75.00)
     Junior middle school 16 (14.03) 40 (17.54)
     Senior high school and beyond 12 (10.53) 17 (7.46)
    下载: 导出CSV

    表  2  糖尿病患者HBV新发感染风险的单因素分析(n=342)

    Table  2.   Univariate analysis of the risk of new HBV infection in diabetic patients (n=342)

    CharacteristicnHBsAg (+)/case (%)HBsAg (−)/case (%)χ2P
    Family history of hepatitis B 25.790 <0.001
     Yes 29 22 (75.86) 7 (24.14)
     No 313 92 (29.39) 221 (76.61)
    History of trauma 6.211 0.013
     Yes 11 8 (72.73) 3 (27.27)
     No 331 106 (32.02) 225 (67.98)
    History of receiving/donating blood 0.016 0.899
     Yes 8 2 (25.00) 6 (75.00)
     No 334 112 (33.53) 222 (66.47)
    History of dental diagnosis and treatment 1.546 0.214
     Yes 105 30 (28.57) 75 (71.43)
     No 237 84 (35.44) 153 (64.56)
    History of traumatic diagnosis and treatment 0.066 0.797
     Yes 249 82 (32.93) 167 (67.07)
     No 93 32 (34.40) 61 (65.59)
    History of invasive cosmetology 0.311 0.577
     Yes 28 8 (28.57) 20 (71.43)
     No 314 106 (33.76) 208 (66.24)
    Diabetic complications 0.048 0.826
     Yes 45 16 (35.56) 29 (64.44)
     No 248 84 (33.87) 164 (66.13)
    Other chronic diseases 0.024 0.877
     Yes 194 64 (32.99) 130 (67.01)
     No 148 50 (33.78) 98 (66.22)
    Sharing toothbrush/towel/razor 0.011 0.916
     Yes 53 18 (33.96) 35 (66.04)
     No 289 96 (33.22) 193 (66.78)
    Self-testing of blood glucose at home 0.684 0.408
     Yes 106 32 (30.19) 74 (69.81)
     No 236 82 (34.75) 154 (65.25)
    Injection of insulin 12.303 <0.001
     Yes 81 40 (49.38) 41 (50.62)
     No 261 74 (28.35) 187 (71.65)
    Type of blood collection needle 59.772 <0.001
     Lancing pen 106 66 (62.26) 40 (37.74)
     Safety lock blood glucose lancet 211 46 (21.80) 165 (78.20)
     Venous blood collection needle 25 2 (8.00) 23 (92.00)
    Standardized use of blood collection/injection devices 23.315 <0.001
     Yes 268 72 (26.87) 196 (73.13)
     No 74 42 (56.76) 32 (43.24)
    下载: 导出CSV

    表  3  糖尿病患者HBV新发感染风险的多因素回归分析(n=342)

    Table  3.   Multivariate regression analysis of the risks for new HBV infection in diabetic patients (n=342)

    CharacteristicβWaldPOdds ratio95% confidence interval
    LowerUpper
    Family history of hepatitis B (no) 2.569 16.641 <0.001 13.052 3.799 44.847
    Standardized use of blood collection/injection devices (no) −1.669 15.253 <0.001 0.189 0.082 0.436
    Blood collection lancet type (blood collection pen type) 36.099 <0.001
     Safety locking bloodglucose needle −1.951 33.259 <0.001 0.142 0.073 0.276
     Venous blood collection needle −3.959 8.781 0.003 0.019 0.001 0.262
    Self-testing of blood glucose at home (no) −0.763 4.049 0.044 0.466 0.222 0.980
     β: Partial regression coefficient.
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-09-04
  • 修回日期:  2021-06-10
  • 网络出版日期:  2021-12-06
  • 刊出日期:  2021-09-20

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